Rotator Cuff Tears

rotator cuff tear anatomy shoulder

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Rotator cuff is a group of 4 muscles and their tendons that together form a « cuff » around the head of the humerus (upper end of the arm). The 4 muscle, originate from the scapula (shoulder blade), are upraspinatus, infraspinatus, subscapularis and teres minor. Tendons of each muscle fit on the humerus tuberosity.

Rotator cuff’s functions :

  • Lift the arm

  • Turn the arm

  • Stabilize the humerus in the joint

Causes

rotator cuff tear anatomy

The causes of a rotator cuff tear can be an acute injury such as a fall or because of chronic wear with tendon degeneration. For people over 40 years old, the pinching of the tendon on the underside of the scapula may participate in tearing.

Diagnosis

Diagnosis of rotator cuff tears is based on an examination and/or diagnosis study such as a MRI (magnetic resonance imaging) to confirm the diagnosis. Diagnosis early on in the first symptoms and rotator cuff’s treatment can help to boost the treatment’s results.

Treatment

Goals treatment are to relieve pain and restore strength to the injured shoulder. Several tears in rotator cuff can be treated without surgery. Anti-inflammatory drugs, steroid injections and physical therapy can all be beneficial in treating the symptoms of a tear in the cuff.

Even though a full-thickness tear needs to be cured with surgery, it’s possible to use non-surgical treatments to have a satisfactory function in some cases.

Surgery

rotator cuff tear anatomy surgery

Surgery is recommended if there is persistent pain or shoulder weakness that doesn’t improve with non-surgical treatment. Often patients who have surgery indicate nocturnal pain and difficulty using the arm for lifting and reaching. Many will indicate persistent symptoms despite several months of treatment and limited use of the arm.

Surgery is also recommended for active people who use the arm for overhead work or sports.

Surgical options

The type of repair performed is based on the findings at surgery. A partial tear my necessarily only a trimming or smoothing procedure called a debridment. A full-thickness tear with the tendon torn from its insertion on the humerus is repaired directly on the bone.

3 techniques are used for rotator cuff repair :

  • Open repair (through a traditional incision)

  • Mini-open repair (partially assisted by a camera view, with a smaller incision)

  • Arthroscopic (performed with only a small camera inserted through multiple small puncture wounds)

Recovery and rehabilitation process

Whether for the treatment of non-surgical and surgical rotator cuff tear, rehabilitation has a very important role. Usually recovery is at least 6 months or more depending on the extent of the tear.

When there is a tear, there is frequently a loss of shoulder movement. An exercise or physical therapy program is needed to restore strength and improve shoulder function.

Although surgery repairs the defect of the tendon, the muscles around the arm remain weak and an important effort is necessary in the rehabilitation so that the procedure is a success. After surgery, a complete re-education can last several months.

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-Steph

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How To Do T-Bar Rows On Feet

t bar rows feet

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Podcast

Knees slightly bent with the bar between your legs. Your take the handles with a pronated grip. Your back is straight and you incline your torso at about 45° :

  • Inspires and brings the bar to your chest

  • Exhale at the end of the movement

This exercise is similar to the barbell bent rows but it allows a better work of the back muscles because there is less need to focus on the body’s positioning.

This exercise works latissimus dorsi, teres major, infraspinatus, rhomboids, the middle part of trapezius and arm’s flexors (biceps, brachialis, and brachioradialis).

Incline your torso works your abs and spinal erectors isometrically.

With a supinated grip, this exercise especially works the brachialis and the upper part of trapezius at the end of the pull.

There are some machines that allow you to have a semi-pronation grip. With a semi-pronation grip, you intensely work the forearms muscles, especially the brachioradialis.

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-Steph

How To Do Seated Rows With A Bar

seated rows with a bar

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Podcast:

Sitting on the machine with your feet on the feet stop. Your torso is bent and you hold the bar with a pronation grip (thumbs inside). Your hands are more apart than the width of your shoulders:

  • Inhale, pull the bar towards your chest by straightening your back with your elbows rise.

  • Exhale at the end of the movement and returns to the starting position by controlling the movement.

This exercise works latissimus dorsi, teres major, posterior deltoid, infraspinatus and teres minor and a little bit the biceps, brachialis, and brachioradialis.

When the shoulders blades get closer, the rhomboids and the middle part the trapezius also work.

During straightening your torso, the spinal erectors also work.

Hands position

  1. With a supinated grip (thumbs outside), you work especially the lower trapezius, rhomboids, and brachialis.

  2. With a pronated grip (thumbs inside), you work particularly posterior deltoid and the middle part of the trapezius.

Attention

Stay focus to keep your back straight because if you round your back, you can have injuries.

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-Steph

Shoulder Stretching

shoulder stretching

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Standing with an arm to the horizontal. You take your elbow with your opposite hand and you pull slowly on your arm to bring your elbow to the opposite shoulder.

Keep this position for 30 seconds to feel the stretch.

This exercise mainly works the deltoid posterior and lateral. It’s important to do this because the teres minor muscles and infraspinatus, which are external rotator muscles of humerus, often have contractures that can create a functional imbalance of the shoulder. This may be, for example, excessive tendon’s friction of the long portion of the biceps in the bicipital groove of the humerus. And the consequences of these contractures can be inflammatory pathologies

This exercise works a little bit the trapezius middle and lower portion and rhomboid major muscle.

Variant : You can pull the elbow with your opposite arm from below.

shoulder stretching

Note : For very muscular persons, the arm’s adduction may be hampered by compression of the brachial biceps on the pectoralis major, which will limit the proper stretching of the shoulder.’s posterior.

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-Steph

Stretch Of The Rotator Cuff’s Posterior Muscles

stretch of the rotator cuff posterior muscles

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Standing with a dumbbell in one hand. You bend your bust forward by holding yourself to a machine (or with a incline bench).

Release your arm and let hang the dumbbell for a minute trying to relax your shoulder.

This exercise stretches your infraspinatus, teres minor muscle, and a little bit your supraspinatus. These muscles are on the posterior side of the scapula.

In bodybuilding, these muscles often contractures and spasms. The consequences are that this can put your shoulder in a bad position and can, over time, create pathologies of wear and tear tendon.

Note : Contratures of spasms of the teres minor muscles and infraspinatus creates an external rotation of the humerus. Which causes an excessive friction of the tendon of the long head of the biceps (in intertubercular furrow of humerus) in the forearm. The consequences are inflammation followed by a rutpture of wear of the tendon.

It’s for this reason that as soon as you have a suspicious contracture, do this stretch to try to relax your muscles.

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-Steph

Pec Deck Rear Deltoid Lateral

pec deck rear deltoid lateral

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Sit on the machine with your torso on the backrest. With your arms outstretched takes the handles :

  • Inspire and spread your arms to straighten your shoulder blades at the end of movement.

  • Exhale

This exercise works your posterior deltoid, infraspinatus and teres minor muscle. And at the end of the movement when you shoulder blades are tightened, it works your shoulder blades, trapezius and rhomboids.

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-Steph

Barbell Front Raises

barbell front raises

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Standing with legs slightly apart. Your back straight with your abs contracted. Place a barball on your thinghs with a pronated grip and you have arms outstrechted :

  • Inhale and raises the barbell until the level of your eyes

  • Back to the start position slowly by avoiding shaking

  • Exhale at the end of the movement

This exercice mainly works your anterior deltoids, your upper pectorals, infraspinatus and a little bit your trapezius, serratus anterior and your short head of your biceps.

If you raise higher up, your posterior deltoids also work to help raise your arms vertically.

This exercice can also be done at the low pulley. Put your back against the machine with the cable passing between your legs.

Note : Your brachial biceps works a little bit in alll anterior elevation of your arm.

Share this article if you think it can help someone you know. Thank you.

-Steph